53-6-702. Definitions.
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53-6-702 . Definitions. As used in this part, the following definitions apply:
(1)"Department" means the department of public health and human services.
(2)"Health maintenance organization" means a health maintenance organization as defined in 33-31-102 .
(a)"Managed health care entity" or "entity" means a health maintenance organization or an insurer regulated under Title 33 that:
(i)contracts for an estimated annual value of $1 million or more of state and federal medicaid funds; or
(ii)operates statewide or covers 20% or more of the medicaid population.
(b)The term does not include:
(i)a provider of health care services under a contract with the department on a fee-for-service basis;
(ii)a medicaid primary care case management service within the meaning of 42 CFR 438; or
(iii)a PACE organization as defined in 42 CFR 460.6 or an accountable care organization as defined in 33-31-102 that has received a waiver under 33-31-201 .
(4)"Program" means an element of the integrated health care system created by this part.